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Q. My father-in-law is diabetic and has heart problems, and now he is having continuous hiccups. Why?

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Jul 31, 2021

Hi doctor,

Father-in-law has sugar and is already on medicines and injections.

He is now having continuous hiccups. He is COVID negative. Attached are some of the tests done. What could be the reason for these hiccups? Kindly give your opinion.

#

Hi,

Welcome to icliniq.com.

According to your statement, your father-in-law has been suffering from continuous hiccups. He is a known case of diabetes mellitus, and he is on medications.

According to his urinalysis report (attachments removed to protect the patient's identity), protein, sugar, blood, ketones, and plenty of pus cells, RBC (red blood cells), epithelial cells are present. Urinalysis report suggests that he may suffer from urinary tract Infections. Ultrasound and X-ray of KUB (kidney, ureter, bladder) region A/P (anteroposterior) view can be done to exclude other causes.

According to his biochemistry studies, his blood urea nitrogen or BUN is high, and serum creatinine level is high, blood sodium level is low, potassium level is above normal, chloride level is low. The serum calcium level is below normal. His BUN is very high, so he may suffer from uremia that can be confirmed by GFR (glomerular filtration rate) and creatinine clearance test. Again, he is suffering from hyponatremia and hyperkalemia, in a word, electrolyte imbalance.

Again, his random blood sugar (RBS) level is very high. His glycated hemoglobin or HbA1c (hemoglobin A1c) level is 10.05% that is high and indicates that past two to three months, his diabetes was totally uncontrolled. A high estimated average glucose level also suggests that.

His ECG (electrocardiogram) tracing report has suggested sinus tachycardia and the possibility of heart block. According to his liver function tests, albumin level is below normal, globulin level is above normal, both SGPT (serum glutamic pyruvic transaminase) and SGOT (serum glutamic-oxaloacetic transaminase) are very high as well as alkaline phosphatase and gamma-glutamyl transferase are also high. His liver function tests have suggested that he may suffer from any liver problems like chronic liver disease.

Hiccups are involuntary contractions of the diaphragm which separate the chest from the abdomen. Each contraction is followed by a sudden closure of the vocal cords and can produce the characteristic "hic" sound. Hiccups may result from some normal conditions to serious medical conditions. Normal conditions are large meals, indigestion, alcohol consumption, carbonated beverages, sudden excitement, stress, etc. Medical conditions are acid reflux or gastroesophageal reflux disease (GERD), uremia, kidney problems, heart problems, electrolytes imbalance, diabetes mellitus, brain tumors, stroke, meningitis, encephalitis, and many more.

In your father-in-law's case, he has been suffering from uncontrolled diabetes mellitus, electrolytes imbalance, uremia or kidney problems, chronic liver disease, heart problems, and many of them may be responsible for his continuous hiccups. Treatment depends on causes. His hiccup will be subsided after treating his present medical conditions.

I hope this was helpful.

Hi doctor,

Thank you.

Regarding the part you mentioned on heart block, he has already got angioplasty done last year. How much is the possibility of heart block do you see? Kindly give your opinion.

#

Hi,

Welcome back to icliniq.com.

His ECG tracing has shown mainly sinus tachycardia and irregular heart rhythm. Such type of ECG changes may result from angioplasty or heart block. Usually, ECG changes may persist for up to seven months in patients who undergo successful angioplasty. So do not be worried about ECG changes. Do an angiogram, and that will confirm everything.

I hope this was helpful.


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